Prostate Diseases (BPH)

If you urinate frequently during the night, and if the strength and speed of your urine flow have decreased and slowed compared to before, you may have benign enlargement of the prostate. It may be advisable to see a specialist before these complaints start to make your daily life difficult.

Men can experience problems caused by prostate enlargement, especially when they reach their 60s. Op. Dr. Ali Aydın explains the reason as follows: “During male development, the prostate develops and grows in two important periods. In the first, during early puberty, the prostate gland doubles in size. In addition, at around the age of 25, the prostate enters a second period of growth. Years later, the growth in this second period results in benign prostatic hyperplasia (benign enlargement of the prostate, BPH for short).”

Op. Dr. Ali Aydın, noting that this continued growth of the prostate actually does not cause problems in most men, states that BPH is very rarely seen in men younger than 40, but that symptoms of BPH are observed in more than half of men in their 60s and in 90% of men in their 70s, affecting their daily life and quality of life. Especially with increasing life expectancy, the frequency of BPH and related complaints is also observed to rise. It is known that in the USA in 2000, BPH accounted for 4.5 million urology visits per year.

What Are the Symptoms of BPH?

Op. Dr. Ali Aydın says the following about the symptoms of BPH: “Among the problems that affect a person's social life, we can mention getting up from sleep to urinate during the night and the need to urinate frequently during the day. These two problems in particular cause difficulties in a person's social life such as lack of sleep, fatigue and constantly looking for a toilet wherever they go. In addition, the strength and speed of the urine flow may have decreased and slowed compared to before. There may be hesitation or straining when starting to urinate, and even after most of the urine has passed, dribbling may still continue. Furthermore, after urinating, the person may feel that the bladder has not emptied completely.”

Noting that prostate enlargement usually occurs as the growth of a benign tumor, Aydın underlines that anyone experiencing problems with urination should therefore definitely consult a doctor.

How Is It Diagnosed?

The diagnostic methods used in the evaluation of benign prostate enlargement can be listed as follows:

• Digital rectal examination of the prostate

• Serum PSA (total and free PSA) and creatinine levels

• Ultrasonography

• Prostate biopsy (when necessary)

• Measurement of urine flow rate (uroflowmetry)

• Cystoscopy (when necessary)

What Are the Treatment Options?

Op. Dr. Ali Aydın emphasizes that the first step in the treatment of BPH must always be medical therapy, and says that if the expected result cannot be obtained with medication, or if the symptoms that had improved recur over time despite treatment, different treatment alternatives should be considered.

As for interventional treatment alternatives, Aydın ranks the best options in order of effectiveness as follows:

“Transurethral resection (TUR), performed with bipolar energy, plasmakinetic energy or monopolar energy

Laser vaporization, performed with KTP, diode or thulium laser

Laser enucleation, performed with holmium laser

Open and laparoscopic prostatectomy (100-120 gr)”

Younger Men Should Also Be Careful!

Apart from benign prostatic enlargement and prostate cancer, another condition known as chronic prostatitis (chronic inflammation of the prostate) can also occur in the prostate gland. The symptoms of this condition, which is seen especially in young men, include frequent urination, a feeling of fullness or dull pain in the testicles or radiating from the base of the penis toward the anus, and a stinging or burning sensation during ejaculation. This chronic infection caused by microbes can be controlled with long-term antibiotic treatment. However, the treatment of inflammation that is not caused by microbes may take longer.